Glutamine-Enriched Nutrition in Trauma Care. Implications for Impaired Immune System and Infectious Complications

Abstract

Major trauma results in a compromised immunity and an increased susceptibility for infections. In ICU patients, a low plasma glutamine is associated with poor clinical outcome. Glutamine, the body's most abundant amino acid, is among others, a precursor for antioxidants and is the preferred respiratory substrate for rapidly dividing cells. Many studies show that plasma glutamine and skeletal muscle glutamine concentrations are decreased by approx 50 % during sepsis, surgery, burns and trauma. This acute glutamine depletion is most likely the result of a higher utilisation of glutamine than the body can provide. Additionally, this reduced vital substrate has an impact on the nitrogen balance, antioxidant supply, substrate for the integrity of the gut and the immune status of the trauma patient. Exogenous glutamine, for instance glutamine-enriched nutrition, can augment the availability of substrate for the function of lymphocytes, macrophages and neutrophils. In a randomised study, we showed that administering glutamine-enriched enteral nutrition results in a reduction of infectious complications in trauma patients.

Key words

Glutamine - trauma care - immune system - infections

References

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